Provider Demographics
NPI:1750039442
Name:LYMPHATIC MASSAGE OF FLORIDA LLC
Entity Type:Organization
Organization Name:LYMPHATIC MASSAGE OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM. MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYURI
Authorized Official - Middle Name:A
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:954-562-6197
Mailing Address - Street 1:15750 WOODGATE CT.
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-669-0065
Mailing Address - Fax:
Practice Address - Street 1:3325 S UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328
Practice Address - Country:US
Practice Address - Phone:954-669-0065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain